PMID- 35416592
OWN - NLM
STAT- MEDLINE
DCOM- 20220530
LR  - 20220531
IS  - 1179-1950 (Electronic)
IS  - 0012-6667 (Linking)
VI  - 82
IP  - 7
DP  - 2022 May
TI  - Adverse Events Associated with Immune Checkpoint Inhibitors: Overview of 
      Systematic Reviews.
PG  - 793-809
LID - 10.1007/s40265-022-01707-1 [doi]
AB  - BACKGROUND: Recognition and management of adverse events (AEs) associated with 
      immune checkpoint inhibitor (ICI) use by cancer patients requires expertise from 
      multiple disciplines. Greater awareness of potential AEs may result in earlier 
      recognition, appropriate management, and better patient outcomes. OBJECTIVE: The 
      primary objective of this overview of systematic reviews was to synthesize and 
      consolidate systematic review evidence describing the incidence proportion and 
      severity of AEs associated with various ICI therapies across different cancers. 
      METHODS: A systematic literature search of four databases was conducted to 
      identify systematic reviews that describe the incidence proportion and severity 
      of AEs related to ICI therapy in cancer patients. A systematic review was 
      eligible if it included adults with cancer; on ICI alone or in combination with 
      another ICI, chemotherapy, or targeted therapy; severity (graded according to the 
      Common Terminology Criteria for Adverse Events) and incidence proportion of AEs 
      and whether it reported its eligibility criteria. AEs of interest were identified 
      through an iterative ranking exercise by key stakeholders and knowledge users. 
      Extraction of PICOTTS elements and quality indicators (AMSTAR-2) were used to 
      manage overlap of primary studies across systematic reviews at the outcome level. 
      Cancer subtypes were mapped to drug class and AE severity. RESULTS: Overall, 129 
      systematic reviews met the inclusion criteria for data mapping. Systematic 
      reviews reported incidence proportions for more than 76 AEs, of which 34 were 
      identified as AEs of interest. After overlap assessment, 65 systematic reviews 
      were chosen for data extraction. The three AEs with the highest median incidence 
      were fatigue (18.3%, interquartile range [IQR] 15.0-28.0%), diarrhea (15.3%, IQR 
      9.7-29.2%) and rash (14.4%, IQR 10.3-19.2%). The three AEs (high-grade) with the 
      highest median incidence were diarrhea (1.5%, IQR 1.2-6.0%), colitis (1.3%, IQR 
      0.6-6.1%) and neutropenia (1.2%, IQR 0.4-3.3%). Incidence proportions of 
      high-grade AEs were often considerably lower than all-grade AEs and combination 
      therapy (ICI combinations or combinations of ICI with chemotherapy or targeted 
      therapy) was responsible for some of the highest incidence proportions regardless 
      of AE. Rare AEs and certain cancer subtypes were not well reported. CONCLUSIONS: 
      Early recognition of AEs associated with ICIs requires expertise from diverse 
      specialists, not just oncologists. Greater awareness of potential AEs may result 
      in earlier recognition, appropriate management, and better patient outcomes. 
      PROSPERO REGISTRATION: CRD42021231593.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Kanji, Salmaan
AU  - Kanji S
AUID- ORCID: 0000-0003-0594-0360
AD  - The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada. skanji@toh.ca.
AD  - Ottawa Hospital Research Institute, Ottawa, ON, Canada. skanji@toh.ca.
FAU - Morin, Sydney
AU  - Morin S
AD  - Montfort Hospital, Ottawa, ON, Canada.
FAU - Agtarap, Kyla
AU  - Agtarap K
AD  - University of Waterloo, Waterloo, ON, Canada.
FAU - Purkayastha, Debanjali
AU  - Purkayastha D
AD  - University of Waterloo, Waterloo, ON, Canada.
FAU - Thabet, Pierre
AU  - Thabet P
AD  - Montfort Hospital, Ottawa, ON, Canada.
FAU - Bosse, Dominick
AU  - Bosse D
AD  - The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
FAU - Wang, Xiang
AU  - Wang X
AD  - The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
FAU - Lunny, Carole
AU  - Lunny C
AD  - St. Michaels Hospital, Unity Health Toronto, Toronto, ON, Canada.
AD  - University of British Columbia, Vancouver, BC, Canada.
FAU - Hutton, Brian
AU  - Hutton B
AD  - Ottawa Hospital Research Institute, Ottawa, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220413
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Adult
MH  - Diarrhea/chemically induced/drug therapy
MH  - Humans
MH  - *Immune Checkpoint Inhibitors/adverse effects
MH  - Incidence
MH  - *Neoplasms/drug therapy
MH  - Systematic Reviews as Topic
EDAT- 2022/04/14 06:00
MHDA- 2022/05/31 06:00
CRDT- 2022/04/13 12:07
PHST- 2022/03/16 00:00 [accepted]
PHST- 2022/04/14 06:00 [pubmed]
PHST- 2022/05/31 06:00 [medline]
PHST- 2022/04/13 12:07 [entrez]
AID - 10.1007/s40265-022-01707-1 [pii]
AID - 10.1007/s40265-022-01707-1 [doi]
PST - ppublish
SO  - Drugs. 2022 May;82(7):793-809. doi: 10.1007/s40265-022-01707-1. Epub 2022 Apr 13.